前次剖宫产术后分娩：近期围生期结局。
Delivery after previous cesarean: short-term perinatal outcomes.
机构信息
Department of Pediatrics, Division of Neonatology, Emory University School of Medicine, Atlanta, GA 30322, USA.
出版信息
Semin Perinatol. 2010 Aug;34(4):272-80. doi: 10.1053/j.semperi.2010.03.007.
Abstract
Women must often choose between a vaginal birth after previous cesarean and elective repeat cesarean delivery. Short-term risks of vaginal birth after cesarean can be potentially catastrophic in the setting of uterine rupture. Although randomized controlled trials comparing these 2 modes of delivery are lacking, observational studies suggest an increased risk of perinatal mortality and hypoxic-ischemic encephalopathy in infants whose mothers undergo a trial of labor. These rare risks compete with more common, albeit less severe, short-term risks associated with elective repeat cesarean delivery, with a particular emphasis on increased respiratory morbidities. Further studies are needed to identify potential strategies to improve perinatal outcomes and help guide physicians and patients in choosing optimal methods of delivery.
摘要
女性在先前剖宫产术后通常需要在阴道分娩和选择性再次剖宫产之间做出选择。在子宫破裂的情况下，阴道分娩后的短期风险可能是灾难性的。虽然缺乏比较这两种分娩方式的随机对照试验，但观察性研究表明，尝试阴道分娩的母亲所生婴儿围产期死亡率和缺氧缺血性脑病的风险增加。这些罕见的风险与与选择性再次剖宫产相关的更常见但不太严重的短期风险相竞争，特别强调增加呼吸系统疾病的发病率。需要进一步研究以确定潜在的策略来改善围产期结局，并帮助指导医生和患者选择最佳的分娩方式。
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